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Elevated C-reactive protein in early COVID-19 predicts worse survival among hospitalized geriatric patients
Adeline Villoteau1,2, Marine Asfar1,2, Marie Otekpo1,2
1School of Medicine, Health Faculty, University of Angers, Angers, France.
Insights
Elevated C-reactive protein (CRP) levels in early COVID-19 indicate higher 14-day mortality risk in elderly patients. A CRP level below 35mg/L was linked to better survival outcomes in this vulnerable group.
Area of Science:
- Geriatric Medicine
- Infectious Diseases
- Biomarkers
Background:
- COVID-19 poses significant risks to geriatric populations.
- C-reactive protein (CRP) is an inflammatory marker with potential prognostic value.
Purpose of the Study:
- To investigate the association between elevated CRP levels in early COVID-19 and 14-day mortality in elderly patients.
- To identify potential cut-off values for CRP predicting mortality.
Main Methods:
- A cohort study of hospitalized geriatric COVID-19 patients.
- Assessment of plasma CRP levels at hospital admission.
- Analysis of 14-day all-cause mortality, adjusting for confounders like age, comorbidities, and treatments.
Main Results:
- Higher baseline CRP levels were observed in non-survivors compared to survivors (120.3±71.2 vs. 67.9±76.1 mg/L, P=0.002).
- Plasma CRP was directly associated with 14-day mortality (fully adjusted HR=1.11, P=0.025).
- A CRP cut-off of 35 mg/L predicted 14-day mortality with 88% sensitivity and 56% specificity.
Conclusions:
- Elevated CRP levels are associated with increased 14-day mortality in hospitalized geriatric COVID-19 patients.
- CRP may serve as a valuable prognostic biomarker for early risk stratification in this population.
Background:
The objective of this cohort study was to determine whether elevated CRP in early COVID-19 was associated with 14-day mortality in geriatric patients.
Methods:
Plasma CRP levels at hospital admission and 14-day all-cause mortality were assessed in geriatric inpatients hospitalized for COVID-19. Potential confounders were age, sex, functional abilities, history of malignancies, hypertension, cardiomyopathy, albuminemia, number of acute health issues, use of antibiotics and respiratory treatments.
Results:
Ninety-five participants (mean±SD 88.0±5.5years; 49.5%women; mean CRP, 76.7±77.5mg/L; mean albuminemia, 32.9±6.0g/L) were included. Sixteen participants who did not survive at day 14 exhibited higher CRP level at baseline than the others (120.3±71.2 versus 67.9±76.1 mg/L, P = 0.002). There was no difference in albuminemia (P = 0.329). Plasma CRP level was directly associated with 14-day mortality (fully adjusted HR = 1.11, P = 0.025). The cut-off for CRP associated with 14-day mortality was set at 35mg/L (sensitivity = 0.88; specificity = 0.56). Those with CRP<35mg/L had longer survival time than the others (log-rank P<0.001).
Conclusions:
Elevated CRP levels were associated with poorer 14-day survival in hospitalized geriatric COVID-19 patients.
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